342701212-9-23-2022-27-AS-KHOS-CJX6QN-20221005210101

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701212
Report Date: 09/23/2022
Date Signed: 09/23/2022 11:17:06 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/15/2022 and conducted by Evaluator Christopher Hopkins-Clarke

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20220915123146

FACILITY NAME:	CARLTON SENIOR LIVING SACRAMENTO ATRIUM		FACILITY NUMBER:	342701212
ADMINISTRATOR:	WIMMER, KASSIE		FACILITY TYPE:	740
ADDRESS:	1071 FULTON AVENUE		TELEPHONE:	(916) 971-4800
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	99	CENSUS: 50	DATE:	09/23/2022
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Kasie Wimmer		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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-Resident not being provided supplies in a timely manner.

INVESTIGATION FINDINGS:

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On September 23, 2022 at 9:10AM, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegations. LPA met with Administrator Kasie Wimmer and stated the purpose of this visit.

Regarding the allegation of Resident not being provided supplies in a timely manner, the Department found the following; based on interview and observation, it was determined that Resident 1 (R1) was provided an extra supply of needed supplies when staff did their checks. LPA observed a good amount of extra supplies in R1's room. R1 stated that he/she never ran out of supplies but was worried because the supply in his/her room was getting low.

LPA has deemed the complaint findings as UNSUBSTANTIATED. Although the allegation may have happened and/or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.
Exit interview conducted. A copy of this report was left with staff upon exit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Christopher Hopkins-Clarke	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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